Privacy Practices

Notice of Privacy Practices

At Dutch Fork Psychological Services, LLC, we place the highest importance on respecting and protecting the privacy of our clients and families.   We want you to feel comfortable and confident when you work with us.   Therefore, we would like to share with you the following principles that govern our information sharing and other privacy aspects of our practice.   Throughout this policy, we refer to information that personally identifies you as Protected Health Information (PHI).

We protect your information.
Dutch Fork Psychological Services protects your PHI from loss, misuse or unauthorized access by using industry-recognized security safeguards.   Paper files are kept in locked cabinets accessible only to us and our staff.   For our computer files we use technology-based systems including encryption, and we follow guidelines and The Code of Ethics set forth by the American Psychological Association.

Dutch Fork Psychological Services is in compliance with all applicable provisions set forth by the Health Insurance Portability and Accountability Act (HIPAA).   The HIPAA law is a multi-step approach that is geared to improve the health insurance system.   We comply with regulations designed to protect your privacy, including facilitating the secure exchange of your private health information with insurance companies with your prior authorization.   At the end of this statement you will find additional HIPAA regulations.

We tell you how we use your information.
All information you provide as part of the initial registration process, diagnostic interviews and testing, and/or ongoing treatment is used solely for the purpose of setting up the client record and for providing requested services.   We maintain both paper and digital client records.   Records are used for maintaining information about the client and family (e.g., contact information), to keep assessment and service data, record time and charges for billing, and to provide data which may be used for treatment planning, progress notes, and formal written reports.

Dutch Fork Psychological Services does not sell or rent your personal information to anyone.   We do not share your personal information with anyone outside of our practice unless you have acknowledged and consented for us to do so (e.g., you may ask us to submit claims to an insurance company or to send a report to a school or medical doctor), or unless the law requires us to do so.   Unless indicated otherwise, the information you provide will be viewed only by us and our staff.   Our associates are supervised and trained by Dr. Haxton and/or Dr. Nowell-Haxton, have signed confidentiality statements on file, and have been educated with regard to confidentiality and privacy issues.

We tell you about our relationships with third parties.
Dutch Fork Psychological Services maintains limited relationships with third parties to assist us in serving you.   We utilize dictation services, an answering service, and other temporary contractual service providers.   All of these providers are contractually required to maintain the confidentiality of the information we provide them.   We also may disclose your information if we are required to by a law enforcement action such as a court order, subpoena or search warrant.

Additional HIPAA Regulations
It is our legal duty to safeguard your Protected Health Information.   By law we are required to insure that your PHI is kept private.   The PHI constitutes information created or noted by us that can be used to identify you.   It contains data about your past, present, or future health condition, the provision of health care services to you, or the payment for such health care.   We are required to provide you with the Notice about our privacy procedures.   This Notice must explain when, why, and how we would use and/or disclose your PHI.   Use of PHI means when we share, apply, utilize, examine, or analyze information within our practice; PHI is disclosed when we release, transfer, give or otherwise reveal it to a third party outside our practice.   With some exceptions, we may not use or disclose more of your PHI than is necessary to accomplish the purpose for which the use or disclosure is made; however, we are always legally required to follow the privacy practices described in this Notice.

Please note that we reserve the right to change the terms of this Notice and our privacy policies at any time.   Any changes will apply to PHI already on file with us.   Before we make any important changes to our policies, we will immediately change this Notice and post a new copy of it in our office and on our Web site (if applicable).   You may also request a copy of this Notice from us, or you can view a copy of it in our office.

We will use and disclose your PHI for many different reasons.   Some of the uses or disclosures will require your prior written authorization; others, however, will not.   Below you will find the different categories of our uses and disclosures, with some examples.

Uses and disclosures related to treatment, payment, or health care operations do not require your prior written consent.   We may use and disclose your PHI without your consent for the following reasons:

  1. For treatment.   We may disclose your PHI to physicians, psychiatrists, psychologists, and other licensed health care providers who provide you with health care services or are otherwise involved in your care.   Example: If a psychiatrist is treating you, we may disclose your PHI to her/him in order to coordinate your care.

  2. We may disclose your PHI to facilitate the efficient and correct operation of our practice.   Examples: We may provide your PHI to our attorney, accountant, consultants, and others to make sure that we are in compliance with applicable laws.

  3. When disclosure is required by federal, state, or local law; judicial, board, or administrative proceedings; or, law enforcement.   Example: We may make a disclosure to the appropriate officials when a law requires us to report information to government agencies, law enforcement personnel and/or in an administrative proceeding.

  4. If disclosure is compelled by a party to proceeding before court of an administrative agency pursuant to its lawful authority.   If disclosure is required by a search warrant lawfully issued to a governmental law enforcement agency.   If disclosure is compelled by the patient or the patient’s representative pursuant to South Carolina Health and Safety codes or to corresponding federal statutes of regulations, such as the Privacy Rule that requires this Notice.

  5. To avoid harm.   We may provide PHI to law enforcement personnel or persons able to prevent or mitigate a serious threat to the health or safety of a person or the public.

  6. If disclosure is compelled or permitted by the fact that you are in such mental or emotional condition as to be dangerous to yourself or the person or property of others, or if we determine that disclosure is necessary to prevent the threatened danger.

  7. If disclosure is mandated by the South Carolina Child Abuse and Neglect Reporting law.   For example, if we have a reasonable suspicion of child or elder abuse.

  8. If disclosure is compelled or permitted by the fact that you tell us a serious/imminent threat of physical violence by you against a reasonably identifiable victim or victims.

  9. For public health activities.   Example: In event of your death, if a disclosure is permitted or compelled, we may need to give the county coroner information about you.

  10. For health oversight activities.   Example: We may be required to provide information to assist the government in the course of an investigation or inspection of a health care organization or provider.

  11. For specific government functions.   Example: We may disclose PHI of military personnel and veterans under certain circumstances.   Also, we may disclose PHI in the interests of national security, such as protecting the President of the United States or assisting with intelligence operations.

  12. For research purposes.   In certain circumstances, we may provide PHI in order to conduct medical research.

  13. For Workers Compensation purposes.   We may provide PHI in order to comply with Worker’s Compensation laws.

  14. Appointment reminders and health related benefits or services.   Example: We may use PHI to provide appointment reminders.   We may use PHI to give you information about alternative treatment options, or other health care services or benefits we offer.

  15. If an arbitrator or arbitration panel compels disclosure, when arbitration is lawfully requested by either party, pursuant to subpoena duces tecum (e.g., a subpoena for mental health records) or any other provision authorizing disclosure in a proceeding before an arbitrator or arbitration panel.

  16. We are permitted to contact you, without your prior authorization, to provide appointment reminders or information about alternative or other health-related benefits and services that may be of interest to you.

  17. If disclosure is required or permitted to a health oversight agency for oversight activities authorized by law.   Example: When compelled by U.S. Secretary of Health and Human Services to investigate or assess my compliance with HIPAA regulations.

  18. If disclosure is otherwise specifically required by law.   Please note, if you are involved in a forensic case with either Dr. Haxton or Dr. Nowell-Haxton (such as a case involving custody determination), the laws which apply to those proceedings and orders of the court may supersede the privacy extended under HIPAA.

Certain uses and disclosures require you to have the opportunity to object.
Disclosures to family, friends, or others.   We may provide your PHI to a family member, friend, or other individual who you indicate is involved in your care or responsible for the payment for your health care, unless you object in whole or in part.   Retroactive consent may be obtained in emergency situations.
Other uses and disclosures require your prior written authorization.   In any other situation not described above, we will request your written authorization before using or disclosing any of your PHI.   Even if you have signed an authorization to disclose your PHI, you may later evoke that authorization, in writing, to stop any future uses and disclosures (assuming that we haven’t taken any action subsequent to the original authorization) of your PHI by us.

These are your rights with respect to your PHI:

  1. The right to see and get copies of your PHI.   In general, you have the right to see your PHI that is in our possession, or to get copies of it; however, you must request it in writing.   If we do not have your PHI, but we know who does, we will advise you how you can get it.   You will receive a response from us within 30 days of our receiving your written request.   Under certain circumstances, we may feel we must deny your request, but if we do, we will give you, in writing, the reasons for the denial.   We will also explain your right to have our denial reviewed.   If you ask for copies of your PHI, we will charge you not more than $.25 per page.   We may see fit to provide you with a summary or explanation of the PHI, but only if you agree to it, as well as to cost, advance.

  2. The right to request limits on uses and disclosures of your PHI.   You have the right to ask that we limit how we use and disclose your PHI.   While we will consider your request, we are not legally bound to agree.   If we do agree to your request, we will put those limits in writing and abide by them except in emergency situations.   You do not have the right to limit the uses and disclosures that we are legally required or permitted to make.

  3. The right to choose how we send your PHI to you.   It is your right to ask that your PHI be sent to you at an alternate address (for example, sending information to your work address rather than your home address) or by an alternate method (for example, via email instead of by regular mail).   We are obliged to agree to your request providing that we can give you the PHI in the format you requested without undue inconvenience.

  4. The right to get a list of the disclosures we have made.   You are entitled to a list of disclosures of your PHI that we have made.   The list will not include uses or disclosures to which you have already consented, i.e., those for treatment, payment, or health care operations, sent directly to you or to your family; neither will the list include disclosures made for national security purposes, to corrections or law enforcement personnel, or disclosures made before April 15, 2003.   After April 15, 2003, disclosure records will be held for six years.

  5. We will respond to your request for an accounting of disclosures within 60 days of receiving your request.   The list we give you will include disclosures made in the previous six years unless you indicate a shorter period.   The list will include the date of the disclosure, to whom PHI was disclosed (including their address, if known), description of the information disclosed, and the reason for the disclosure.   We will provide the list to you at no cost, unless you make more than one request in the same year, in which case we will charge you a reasonable sum based on a set fee for each additional request.

  6. The right to amend your PHI.   If you believe that there is some error in your PHI or that important information has been omitted, it is your right to request that we correct the existing information or add the missing information.   Your request and the reason for the request must be made in writing. You will receive a response within 60 days of our receipt of your request.   We may deny your request, in writing, if we find that: the PHI is (a) correct and complete, (b) forbidden to be disclosed, (c) not part of our records, or (d) written by someone other than us.   Our denial must be in writing and must state the reasons for the denial.   It must also explain your right to file a written statement objecting to the denial.   If you do not file a written objection, you still have the right to ask that your request and our denial be attached to any future disclosures of your PHI.   If we approve your request, we will make the change(s) to your PHI.   Additionally, we will tell you that the changes have been made, and we will advise all others who need to know about the change(s) to your PHI.

  7. The right to get this notice by email.   You have the right to get this notice by email, as well as request a paper copy of it.

If, in your opinion, we may have violated your privacy rights, or if you object to a decision we made about access to your PHI, you are entitled to discuss this directly with us.   You may also send a written complaint to the Secretary of the Department of Health and Human Services at 200 Independence Avenue, S.W.   Washington, D.C.   20201.   If you file a complaint about our privacy practice, we will take no retaliatory action against you.

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